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Of Vice and Medicine: A Catholic Perspective On Marijuana Legalization In The United States

In the run-up to the 2016 presidential election, Archbishop Samuel J. Aquila of the Archdiocese of Denver published a letter on the website of the Denver Catholic giving advice to the faithful on how their Catholic conscience should influence their vote. He noted:

“If you truly live your Catholic faith, you will not find complete alignment with any political party. . . Our society suffers and has suffered for quite some time because too few people live an integrated life – one that does not divide “the personal” from “the public.”

The Archbishop’s statement clarifies two critical points: (1) there is, in fact, a “Catholic” view of political issues that is independent of political party labels and orthodoxy; and (2) Catholics are called upon to integrate their faith into their public affairs (including when exercising their basic political franchise).

While the Archbishop was writing specifically about voting in the presidential election, these principles can be applied to decisions that Catholics face on a host of political issues including abortion, physician-assisted suicide, even criminal justice reform and immigration policy. Accordingly, it is the same Catholic perspective that must be understood and applied to the issue of drug policy in the United States, and the legalization of marijuana in particular.

As of the writing of this article, 29 States in the United States have legalized marijuana for either solely medical purposes, or for both medical and recreational use. This has been accomplished through both a public referendum process and, more recently, through a bicameral legislative process in certain States. According to research conducted by the Pew Research Center, 61% of Americans surveyed favor legalizing marijuana in some fashion. Despite this public sentiment, marijuana remains a controlled substance under the Federal Controlled Substances Act and, therefore, its use, cultivation, possession and distribution remains a crime under Federal law. Confronted with this dichotomy, and in deference to the Archbishop’s admonition about the necessity for engaged Catholics integrating the precepts of their faith into their public lives, it is essential for Catholics to understand basic doctrine and social teachings of the Church on this issue when formulating their opinions. As more fully set forth below, the Church teachings on the matter are manifested in both codified doctrine, and the pronouncements of several prelates and representatives within the Church. Additionally, the work of Catholic scholars and ethicists further elucidates the matter. They reveal a balanced and measured view: one that condemns the use of marijuana and other drugs for purely recreational purposes, while recognizing their potential benefits for therapeutic purposes.

The Primacy of the Catechism

As a threshold matter, to understand the Church’s position on marijuana use, it is critical to understand the issue in the context of codified Church doctrine. The sine qua non of Catholic social teaching is The Catechism of the Catholic Church. The current Catechism was promulgated in 1992 by Pope John Paul II following six (6) years of work involving all Catholic Bishops, and various theological and catechetical institutes. According to the United States Council of Catholic Bishops, the Catechism serves several important functions, including:

It conveys the essential and fundamental content of Catholic faith and morals in a complete and summary way.

It is a point of reference for national and diocesan catechisms.

It is a positive, objective and declarative exposition of Catholic Doctrine.

It is intended to assist those who have the duty to catechize, namely promoters and teachers of the catechesis.”

Moreover, it is also clear that the Catechism is intended specifically for “bishops as teachers of faith and pastors of the church”, and was specifically referred by Pope John Paul II as “… a statement of the Church’s faith and of Catholic Doctrine, attested to or illuminated by sacred scripture, Apostolic Tradition and the Church’s Magisterium. Accordingly, on issues such as drug use and legalization, in general, and marijuana use, in particular, an analysis of the

Catechism is an indispensable first step in understanding the position of the Church and the teachings of its senior leaders, including bishops, regarding the same.

The Catechism Condemns Drug Use for Recreational Purposes

The Catechism categorically condemns recreational drug use as sinful and harmful to the individual, noting:

“The use of drugs inflicts very grave damage on human health and life. Their use, except on strictly therapeutic grounds, is a grave offense. Clandestine production of and trafficking in drugs are scandalous practices. They constitute direct cooperation in evil, since they encourage people to practices gravely contrary to the moral law”.

Pope Francis has made several public statements which echo The Catechism’s pronouncement condemning recreational drug use, calling it “a scourge”, and proclaiming that there is “no room for illicit drugs, for alcohol abuse, [or] other forms of addiction.” In the Fall of 2016, the Vatican held a two (2) day conference entitled: “Narcotics: Problems and Solutions of this Global Issue”. At this conference, the Pope referred to drug addiction as “a new form of slavery”, and those who abuse drugs as having “lost their freedom.” In short, the Pope has been quite adamant that the Church opposes legislation which would legalize drugs for recreational purposes.

Accordingly, the plain text of the Catechism, together with a variety of statements from the head of the Church, make it quite clear that the Catholic Church condemns recreational drug use and, by extension, the efforts of certain segments of society and government which have facilitated their legalization and access to the general public for recreational purposes.

The Church Does Not Condemn Drug Use for Medical Purposes.

The plain text of the Catechism exempts from the general prohibition against drug use, the use of drugs for “therapeutic” reasons. Unlike certain other Christian sects, the Church does not discourage its followers from seeking and obtaining medical treatment where the same is useful or necessary to maintain or restore health. Accordingly, the therapeutic use exception incorporated within the Catechism is consistent with the Church’s desire to function in modern society, and recognizes the utility of medical technologies that do not offend basic moral tenets.

There is a logical textual argument that medicinal marijuana is, itself, exempted from the general prohibition on drug use under paragraph 2291 of the Catechism. As a threshold matter, paragraph 2291 of the Catechism doesnot distinguish between synthetic manmade drugs, and so-called “plant-based” drugs such as marijuana. It also does not specifically address the morality or acceptability of a drug which is lawfully prescribed in some territories of a country, but is illegal in other territories (i.e. the State and Federal Government divide in the United States). Rather, the Catechism discusses “drugs” as a general matter which is consistent with its intention to serve as a universal document to be understood and followed by the Church faithful worldwide. The distinction the Catechism does draw is between drugs used for therapeutic (read “medicinal”) purposes and non-therapeutic (read “recreational”) purposes. To that end, it is reasonable to assume that the word “marijuana” or is interchangeable with the word “drugs” for purposes of paragraph 2291 and, thus, the Catechism itself expressly permits the therapeutic use of marijuana, but prohibits the recreational use of marijuana; to wit: paragraph 2291 can be logically revised to read: “The use of marijuana (or cannabis) inflicts very grave damage on human health and life. Its use, except on strictly therapeutic grounds, is a grave offense.”

Several Prominent Church Leaders have Endorsed Medical Marijuana as a Legitimate Medical Treatment.

The concept of marijuana as a potentially valuable medical treatment has been advanced by several high-ranking Church officials both here in the United States and elsewhere. In 2015, Cardinal Norberto Rivera of Mexico indicated that the Church had no issue with the medicinal use of marijuana noting that “all elements from nature . . .can be used to improve health.” Furthermore, in April of 2016 in the midst of a public debate in the Iowa Legislature about the passage of a medical marijuana bill, Bishop Richard Pates of the Diocese of Des Moines asked members of the State House and Senate in Iowa to approve a proposed bill stating: “ I believe now is the time to help suffering Iowans and their families get access to this medicine”. Moreover, Father Kenneth Doyle of the influential Catholic News Service noted in a 2017 article that:

“When used. . .(with proper controls) for medical reasons, its use cannot only be permitted by applauded; research has found medical marijuana effective for certain patients with epilepsy, bipolar disorders, cancer, etc.-as well as for some children with severe autism.”

Finally, in one of the more comprehensive expositions on the subject, Archbishop Socrates Villegas, President of the Catholic Bishops’ Conference of the Philippines, said in an August 16, 2016 statement entitled “Pastoral Guidance on the Compassionate Use of Cannabis” that:

“The Highest teaching authority of the Church allows for the palliative and compassionate use of narcotics, particularly in the case of the terminally ill. We have been apprised of various medical situations other than terminal illness where it seems that palliative cure and relief involving the use of narcotics including cannabis may be indicative. The obligation to treat subsists, even when it may not be possible to cure. We appeal therefore to the prudent and Spirit-filled discernment of our health care workers, particularly our physicians, to apply the principle of proportionality and to determine carefully whether there is due proportion between the risks involved in the use of narcotics and psychotropic substances and the benefits anticipated.”

The Archbishop’s statement is a further exemplification of the basic principle expressed in the Catechism that drugs, including marijuana, that have a therapeutic benefit may be morally used for medicinal purposes.

Accordingly, the assertion that the Church simultaneously condemns the use of marijuana recreationally, while supporting its use solely for medicinal purposes, is supported by both a rational interpretation of the text of the Catechism, as well as recent pronouncements from high-level officials within the Church.

Marijuana is regularly touted by legalization advocates as an alternative therapy to manage pain in patients with chronic, debilitating and/or terminal conditions. For its part, the Church has long advocated for pain management for suffering patients, condemning the practice of physician-assisted suicide and espousing a fundamental principle that all life is sacred from conception to the point of natural death. Additionally, while Church teaching condemns the use of drugs designed to end or hasten the end of human life, it specifically supports their use to help patients manage the pain associated with debilitating medical conditions.

Both Catholic and secular medical ethicists are considering medical marijuana and its potential utility as part of a palliative care treatment protocol, viewing it no differently than other medical treatments used for pain management. In writing about the work of Catholic ethicists

who are considering the potential utility of medical marijuana, Tom Tracy of the Catholic News Service points out that: “while marijuana is known to have harmful side effects especially on young users and is prohibited by federal law, it also has been shown to be effective therapy for persons with glaucoma, certain types of cancer, AIDS, end of life diseases in which persons suffer lack of appetite, skin breakdowns and general weakness.” Additionally, Mercy Sister Patricia Talone, vice president of mission services at the St. Louis based Catholic Health Association states:

“[You have to look at medical marijuana] the same way you judge any treatment in terms of benefits and burdens: One would have to judge marijuana in light of a specific person. If this is something that could increase the appetite and quality of life of someone in the hospice program, for example, then the medical use may be acceptable.”

In writing about cannabinoid use to help manage pain in patients with varying medical conditions, Dr. SK. Aggarwal of Auburn Medical Center and the MultiCare Institute for Research and Innovation notes:

“With regard to conditions relevant to oncology, cannabis medicines, both orally administered and inhaled, have been shown in randomized double-blind placebo-controlled trials to have efficacy for a number of symptoms, including opioid-refractory cancer pain, nausea and vomiting secondary to active chemotherapy, appetite stimulation and weight gain in patients with AIDS wasting syndromes, painful HIV sensory neuropathy, and chronic intractable neuropathic pain from multiple causes.”

Therefore, as noted above, from the perspective of both Catholic and secular medical ethicists, marijuana is not categorically rejected due to its reputational stigma as a recreational drug. Rather, it is viewed, analyzed and assessed, along with other treatment modalities, for its potential efficacy in treating a variety of symptomologies. Unfortunately, most of the much-needed research is not happening in the United States due to regulatory constraints. Perhaps it is those very barriers that will provide the catalyst for engagement by ethicists and medical professions (faith-based and otherwise) as the efficacy and benefit of cannabis and its derivatives become more readily verifiable in patient populations in countries without these restraints.

Medical Marijuana May Further the Cause of Catholic Social Justice by Providing Cost-Effective Access to Care

A pillar of Catholic teaching on social justice is that society must “help in the attainment of living conditions… food and clothing, housing, health care, basic education and social assistance.” Unfortunately, for most U.S. consumers the ever-increasing costs of prescription medication makes it difficult for many to afford the medicines that they need. Dr. Sudip Bose, MD points out in his piece, “The High Cost of Prescription Drugs in the United States” that:

“If you look at the landscape of prescription drugs in America, you’ll notice there is nothing taking place to keep drug prices low. There are no specific regulations to keep a ceiling on costs. The pharmaceutical manufacturers have the very tempting opportunity to charge whatever they think a drug’s demand and the market will bear. It’s simply possible for a drug company to charge high prices if they want to us because they can.”

According to data collected by AARP, the average price of retail drugs for older Americans jumped 15.5% between 2014 and 2015 (which represented the fourth straight year of

double-digit increases). The pricing story for medical marijuana, however, is far happier for consumers. For example, in Colorado since adult use of marijuana became legal in 2014, medical marijuana prices have seen a steady decline. In January of 2017, the average retail price for a gram of marijuana at a Colorado adult use dispensary was $6.65. By October of 2017, that price had declined by 12 percent.

In his article entitled “The Healing Community: A Catholic Social Justice Critique of Modern Health Care”, Rev. D. Paul Sullins, Professor of Sociology at the Catholic University of America and the Director of the Summer Catholic Institute of Social Thought, writes:

“In the United States, access to medical care is obstructed by the high cost of care at all levels. There are many differences of opinion over how to solve this problem, but can be little question about the existence of the problem itself. The facts speak for themselves. This year over two million Americans will declare bankruptcy due to medical costs, indeed, healthcare expense is the most frequent cause of personal financial collapse in the United States.”

The high cost of pain management protocols (particularly for the poor and uninsured) require the afflicted to often choose between bankruptcy or living with debilitating pain. This is directly contrary to the Church’s view that access to healthcare is a fundamental human right. Also, traditional pharmacologic pain protocols require access to physicians, frequent doctor’s visits, and high-cost prescription medications, and alternative therapies which de-emphasize the use of highly addictive opioid medications are often not covered by insurance.

Access to medical cannabis, however, at least in States with a functional medical cannabis program, offer the potential for ready access to an effective pain management drug at a substantially decreased cost. In his letter to Members of Congress in 2009, Bishop William Murphy, the head of the Diocese of Rockville Center, New York and the then Chair of the U.S. Bishop’s Committee on Domestic Justice and Human Development, encapsulated the Church’s position concerning the then pressing issue of national health care reform as follows:

“Reform efforts must begin with the principle that decent health care is not a privilege, but a right and a requirement to protect the life and dignity of every person. … The bishops’ conference believes health care reform should be truly universal and it should be genuinely affordable”

If medical cannabis holds the prospect of providing ready access to lower cost, and effective pain management for patients, particularly those in need of end of life care, then its use would appear not only acceptable for purposes of Church doctrine, but directly aligned with a crucial social justice priority of the Church: that health care and treatments should be readily available to all, regardless of their economic position in society.

Conclusion and Recommendations

As noted above, while current Church teaching on cannabis legalization in the United States is not one dimensional, it is readily ascertainable and the following can be clearly distilled:

The Church unequivocally condemns the use of drugs (including marijuana) for purely recreational purposes.

There is support in Church doctrine for the ethical and moral use of drugs for therapeutic purposes. There is a logical argument that “drugs” can be interpreted to include cannabis and, thus, the therapeutic use of cannabis is permitted by doctrine. This view is espoused by several prominent figures within the Church, as well as Catholic ethicists.

There may be a growing acceptance of medicinal marijuana as being compatible with the universal social teachings of the Church respecting palliative care and pain management, as well as universal access to effective medications.

When assessing whether to support marijuana legalization initiatives in their home States, American Catholics can look to fundamental church teachings, as well as statements from various Church prelates and ethicists, to inform their decision-making. Viewed in this context, the legalization of marijuana and its use for purely recreational purposes is condemned by the Church, notwithstanding the state of the law in various jurisdictions within the United States. On the other hand, legalization of cannabis for solely medical purposes in a well-regulated marketplace seems not only be permissible under the social teachings of the Church, but could be championed as a useful and necessary societal step in furthering the cause of universal and low-cost access to healthcare.

Address of his Holiness Pope Francis to Participants in the Meeting sponsored by the Pontifical Academy of Sciences on Narcotics: Problems and Solutions to this Global Issue, November 24, 2016 http://www.pas.va/content/accademia (last visited)

See, e.g., the pronouncement by the United States Conference of Catholic Bishops on the use of stem cell research from adult tissue and umbilical chord blood, “Catholic Support for Ethically Acceptable Stem Cell Research”, http://www.usccb.org/issues-and-actions/human-life-and dignity/stem-cell-research (last visited March 5, 2018).

Note, while marijuana is the flowering component of the cannabis plant, the terms are used interchangeably in this article.

See Catechism (2279) which reads “Even if death is though imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only.”

Since the Controlled Substances Act schedules marijuana as a “Schedule 1” drug, it is deemed to have no medical benefit. Accordingly, research into its therapeutic effects is banned by Federal law which hinders research in the United States.

Catechism (2288)

Sudip Bose, M.D., The High Cost of Prescription Drugs in the United States, Huffington Post, August 29, 2017.

Richard McBrien, “What the Church Teaches on Health Care Reform”, National Catholic Reporter, October 9, 2009

About the Author: James Carlon is a partner in the law firm of Diserio Martin O’Connor & Castiglioni LLP, a full-service firm with offices in Connecticut, New York and Massachusetts He is a parishioner at St. Francis of Assisi Church in Weston, CT, and resides in Weston with his family.

“God wishes to establish the devotion to my Immaculate Heart throughout the world.”

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